Provider Demographics
NPI:1619010121
Name:TUFFT, ROBERT DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
Last Name:TUFFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 MCCLURE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3505
Mailing Address - Country:US
Mailing Address - Phone:510-444-2155
Mailing Address - Fax:510-444-0274
Practice Address - Street 1:2930 MCCLURE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3505
Practice Address - Country:US
Practice Address - Phone:510-444-2155
Practice Address - Fax:510-444-0274
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0381130207RG0300X, 207R00000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0027060Medicaid
CAZZZ15233ZMedicare ID - Type Unspecified
CAA47363Medicare UPIN